How can human technology improve the scheduling of unplanned surgical cases?

Human technology in health care includes managerial knowledge required to marshal a health care workforce, operate hospitals and equipment, obtain and administer funds, and, increasingly, identify and establish markets. In this article, the authors focus on human technology and improvement of decision-making processes in the context of operating theatre scheduling of unplanned surgical cases. Unplanned surgery refers to unscheduled and unexpected surgical procedures in distinction to planned, elective surgery. The management of unplanned surgery is a strategic function in hospitals with potential clinical, administrative, economical, social, and political implications. Making health care management decisions is complex due to the multidisciplinary and the multifocussed nature of decision-making processes. The complexity of multidisciplinary and multifocussed decision-making is further exacerbated by perceived professional identity differences. This article presents findings from interviews with doctors and nurses about the scheduling of unplanned surgical cases. The interviews focused on current decision- making determinants, the acceptability of using a model to guide decision-making, and enablers and barriers to implementing the model. The key finding was the limited practicality of a model to guide the scheduling of unplanned surgery. While it could guide decisions around clinical determinants, logistical determinants, and ideal timeframes, it would have difficulty reshaping inter- and intra-professional dynamics.